Older adults who are in the hospital with COVID-19 die at double the rate compared to people who are hospitalized for flu complications, a new study published recently in The BMJ shows.

A team from the Beth Israel Deaconess Medical Center (BIDMC) in Boston used Medicare data from 883,394 Medicare beneficiaries over the age of 65. They were admitted and then discharged between March 2020 and August 2022. The team compared the results to that of 56,409 Medicare beneficiaries who were hospitalized and then sent home for having the flu between March 2018 to August 2019. The study was funded by the National Health, Lung, and Blood Institute.

Though people with COVID-19 had lower rates of comorbidities, they had a 10.9% risk of dying within 30 days of being discharged compared to people who had the flu, who had a 3.9% rate. That same higher death rate was 15.5% in people with COVID-19 compared to 7.1% with the flu at 90 days after being discharged. At 180 days post-discharge, people with COVID-19 had a 19.1% death rate compared to people with the flu, who had a 10.5% rate.  

“The 30-day risk of death after hospital admission with COVID-19 peaked at 17.9% in May 2020 but decreased to 7.2% by the end of the study period,” the authors wrote. “Although this finding may be due to differences in the biology of SARS-CoV-2 and influenza viruses, it may also reflect differences in baseline immunity between cohorts, either from previous infection or from vaccination, though we were unable to evaluate the underlying mechanism in this study.”

People who had COVID-19 had a sixfold higher rate of in-hospital deaths. Of those studied, 16.6% of Medicare enrollees died while they were in the hospital for COVID-19. That compares to 2.7% of those hospitalized for flu.

“Our findings suggest the continued need to evaluate clinical and societal interventions that address the glaring inequities in post-discharge outcomes among older adults hospitalized with COVID-19,” the study said.